Texas MD Jurisprudence Exam Questions With Complete
Solutions
In what cases/situations can minors consent?
- Active duty military
- 16 and "emancipated" (live separate from parents and
managing their own affairs)
- For STD treatment
- addiction treatment
- abuse or suicide prevention
- for pregnancy treatment except abortion.
What is the order of Surrogate consents? At least through the
family chain.
for minors?
for adults?
For minors: Parent -> grandparents -> adult sibling ->
aunt/uncle -> educational institutions with written authorization
-> any adult with written authorization -> court if there is an
active suit affecting parent/child relationship -> peace officer
who has taken custody
For adults: Spouse -> adult child who is sole decision maker ->
majority of adult children -> parent(s) -> adult sibling -> a
person clearly designated by the patient prior to incapacitation -
> nearest relative -> clergy
,A surrogate decision-maker cannot pick a new surrogate. If they
are unwilling or unable to make decisions, it passes down the
line.
No proxy consent is allowed for abortion, ECT, or
psychosurgery. These require the patient themselves to consent
directly; if the patient is unable to then these generally cannot be
pursued. Exception is court appointed guardian for ECT in the
setting of a patient who typically is no longer able to care for
their basic needs or for abortion in the case of unemancipated
minors (where the court is able to act as a temporary guardian).
Who determines Involuntary mental health admission?
A psychiatrist and the court
Cannot be done by proxy
Sexual misconduct
sexual misconduct to ever have sexual contact with a patient
(including request and suggestion of it).
Even if it's a former patient if the physician uses or exploits
trust, knowledge, emotions, or influence derived from the
professional relationship.
Special restrictions for doctors with blood borne pathogen?
Physicians can't practice "exposure-prone" procedures (like
surgery) if they have HIV or Hepatitis B or C, unless approved
by an expert review panel and the patient consents. You can,
however, do invasive procedures that are not deemed "exposure
,prone" without any restriction or obligation to inform your
patients so long as you use universal precautions.
Do you need consent for HIV testing?
Consent for HIV testing is required except when it's necessary
(needle stick; person is a suspected rapist; person is getting
surgery or is a needle-stick risk and they have high-risk
behavior/etc.) In fact, all needle sticks require subsequent testing
for HIV, Hep B, and Hep C.
Voluntary Psychiatric admission can be done by who?
- A parent/guardian can "volunteer" their child under 16 for
"voluntary" admission.
- After 16, the child must also consent to voluntary
admission.
- Adults over 18 can obviously admit themselves.
- (No consent is required for involuntary admission. That's
because it's involuntary.)
What is a APOWW (Apprehension by a peace officer without
warrant)? What are the timelines for evaluation?
An APOWW (Apprehension by a Peace Officer Without
Warrant) is filed by the police when there is suspicion for risk of
injury to self or others.
A physician must physically evaluate the patient within 12
hours (unlike 72 hours for a voluntary admission).
A psychiatrist must then clear the APOWW within 48 hours
or file for an OPC (order of protective custody) to be issued
by a judge. Emergency detention must only be used if the patient
, is an imminent risk and it is deemed the least restrictive means
for safety.
When can restraints be used?
Only if there is an immediate danger to self or others.
physician must document necessity when using restraints or
administering non-consented psychoactive medications (i.e.
emergency antipsychotics / sedatives)
How long does an order of protective custody last? What
happens next? What can the patient request? After how long can
you files for indefinite commitment?
Can a patient refuse psychoactive medications?
- A temporary hospitalization under a judge-issued Order of
Protective Custody (OPC) lasts up to 30 days, after which one
has to file for a 90-day commitment.
The patient has the right to request a probable cause hearing
within 72 hours to try to get released.
- Can file for indefinite commitment after 60 days
- The court orders for involuntary admission and for
mandatory psychoactive medications are separate. A patient
can be committed but able to refuse medications, and another
can be an outpatient but obliged to take meds.
When is electroconvulsive therapy available? who can consent?
Solutions
In what cases/situations can minors consent?
- Active duty military
- 16 and "emancipated" (live separate from parents and
managing their own affairs)
- For STD treatment
- addiction treatment
- abuse or suicide prevention
- for pregnancy treatment except abortion.
What is the order of Surrogate consents? At least through the
family chain.
for minors?
for adults?
For minors: Parent -> grandparents -> adult sibling ->
aunt/uncle -> educational institutions with written authorization
-> any adult with written authorization -> court if there is an
active suit affecting parent/child relationship -> peace officer
who has taken custody
For adults: Spouse -> adult child who is sole decision maker ->
majority of adult children -> parent(s) -> adult sibling -> a
person clearly designated by the patient prior to incapacitation -
> nearest relative -> clergy
,A surrogate decision-maker cannot pick a new surrogate. If they
are unwilling or unable to make decisions, it passes down the
line.
No proxy consent is allowed for abortion, ECT, or
psychosurgery. These require the patient themselves to consent
directly; if the patient is unable to then these generally cannot be
pursued. Exception is court appointed guardian for ECT in the
setting of a patient who typically is no longer able to care for
their basic needs or for abortion in the case of unemancipated
minors (where the court is able to act as a temporary guardian).
Who determines Involuntary mental health admission?
A psychiatrist and the court
Cannot be done by proxy
Sexual misconduct
sexual misconduct to ever have sexual contact with a patient
(including request and suggestion of it).
Even if it's a former patient if the physician uses or exploits
trust, knowledge, emotions, or influence derived from the
professional relationship.
Special restrictions for doctors with blood borne pathogen?
Physicians can't practice "exposure-prone" procedures (like
surgery) if they have HIV or Hepatitis B or C, unless approved
by an expert review panel and the patient consents. You can,
however, do invasive procedures that are not deemed "exposure
,prone" without any restriction or obligation to inform your
patients so long as you use universal precautions.
Do you need consent for HIV testing?
Consent for HIV testing is required except when it's necessary
(needle stick; person is a suspected rapist; person is getting
surgery or is a needle-stick risk and they have high-risk
behavior/etc.) In fact, all needle sticks require subsequent testing
for HIV, Hep B, and Hep C.
Voluntary Psychiatric admission can be done by who?
- A parent/guardian can "volunteer" their child under 16 for
"voluntary" admission.
- After 16, the child must also consent to voluntary
admission.
- Adults over 18 can obviously admit themselves.
- (No consent is required for involuntary admission. That's
because it's involuntary.)
What is a APOWW (Apprehension by a peace officer without
warrant)? What are the timelines for evaluation?
An APOWW (Apprehension by a Peace Officer Without
Warrant) is filed by the police when there is suspicion for risk of
injury to self or others.
A physician must physically evaluate the patient within 12
hours (unlike 72 hours for a voluntary admission).
A psychiatrist must then clear the APOWW within 48 hours
or file for an OPC (order of protective custody) to be issued
by a judge. Emergency detention must only be used if the patient
, is an imminent risk and it is deemed the least restrictive means
for safety.
When can restraints be used?
Only if there is an immediate danger to self or others.
physician must document necessity when using restraints or
administering non-consented psychoactive medications (i.e.
emergency antipsychotics / sedatives)
How long does an order of protective custody last? What
happens next? What can the patient request? After how long can
you files for indefinite commitment?
Can a patient refuse psychoactive medications?
- A temporary hospitalization under a judge-issued Order of
Protective Custody (OPC) lasts up to 30 days, after which one
has to file for a 90-day commitment.
The patient has the right to request a probable cause hearing
within 72 hours to try to get released.
- Can file for indefinite commitment after 60 days
- The court orders for involuntary admission and for
mandatory psychoactive medications are separate. A patient
can be committed but able to refuse medications, and another
can be an outpatient but obliged to take meds.
When is electroconvulsive therapy available? who can consent?
